


Fifteen Things Caregivers Should Know

by compo67



Series: Chicago Verse [121]
Category: Supernatural
Genre: Angst with a Happy Ending, Character Growth, Curtain Fic, Depression, Domestic, Emotional Baggage, Established Dean Winchester/Sam Winchester, Established Relationship, Grumpy Old Men, M/M, Medical Trauma, Old Married Couple, POV Dean Winchester, Post-Series, Recovery
Language: English
Status: Completed
Published: 2018-05-03
Updated: 2018-05-03
Packaged: 2019-05-01 13:45:01
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 1,622
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/14521854
Author URL: https://archiveofourown.org/users/compo67/pseuds/compo67
Summary: From the hospital’s caregiver respite room, Dean printed out a variety of articles.The most useful one so far--which he carries with him in the back pocket of his jeans--has been “Fifteen Things Caregivers Should Know After a Stroke.” It was published by the American Heart Association and the American Stroke Association. They obviously know their shit.





	Fifteen Things Caregivers Should Know

 

From the hospital’s caregiver respite room, Dean printed out a variety of articles.

The most useful one so far--which he carries with him in the back pocket of his jeans--has been “Fifteen Things Caregivers Should Know After a Stroke.” It was published by the American Heart Association and the American Stroke Association. They obviously know their shit. 

He should print out another copy and staple it to the back of his hand. 

Caring for Sam is nothing new to him. Hardly. 

But there’s a difference between taking care of Sam the baby, Sam the kid, Sam the snotty teenager, Sam the stubborn adult, Sam the hunter, and Sam the survivor of a stroke. The difference might as well be as wide as the Grand Canyon as just as overwhelming. 

Instincts and old habits told Dean to refuse an in-home nurse for the first four weeks of recovery. He doesn’t like strangers in their homes. Of course, no one stays a stranger to Dean that long. Thanks to the those same instincts and habits, he ran a background check on Walter, the aid the hospital recommended. Dean spent hours on the phone with contacts and insiders. He called in favors, pulled strings, and amassed more information on Walter than the FBI collects on new recruits. 

Before Walter started his first day, Dean prepped the house while Sam napped. 

Someone needs to write a room by room preparedness checklist for hunters. Dean knows each step from experience, but he’s become a big fan of checklists. They’re handy as fuck. 

Walter was allowed to start his first day in Dean’s unwavering presence. This served a dual purpose--to make sure Walter was the real deal and that Sam would accept the help. Two minutes into his shift, Walter sat down with Sam on the couch and started telling him stories based on his experience growing up in Kansas City. The son of a jazz musician and neurosurgeon, Walter shared that becoming an in-home nurse and playing clubs on the side was the best compromise. Help people physically heal during the day, help them spiritually heal at night. 

On the third visit, Walter brought a book of poems he had written and asked Sam if he’d do the honor of reading a few out loud. 

The stories and poems kept Sam distracted enough to allow Walter to work on getting vitals and measuring progress in terms of speech, movement, and energy. 

Monday, Wednesday, and Friday, Walter showed up for a solid month, never one minute late for his two hour shift.

Dean gradually moved from sitting in the living room with them to cooking in the kitchen or running a quick errand. Walter made things easier from a medical perspective. 

Accepting help is number eleven on the list of fifteen things caregivers should know. 

And as far as Dean can tell two months out from the hospital, that was the easiest part.

Living off the grid his entire life did not adequately prepare him for the many complexities civilians face after a major medical trauma. Angels, witches, and healers don’t bother with health insurance. Imagine asking an angel what they charge for co-pays. Does it count towards the deductible? Out of pocket max? 

Dean thought he had a pretty good understanding of his limit for patience. 

Then he got the hospital bill. 

And five claims were denied.

And more benefits were denied due to a processing error. 

And he had to get pre-authorization for physical therapy. 

He has gone through customer service reps and supervisors like candy. It’s like no one seems capable of doing their jobs--even at the most basic level of competency--without Dean being incredibly pissed off. 

It took no less than fourteen calls between the insurance, the hospital, Sam’s specialists, and the third-party company responsible for processing claims to get the green light for physical therapy. 

Most of Sam’s recovery has been at home because of Walter, Mrs. Martinez, Kevin, and Dean. 

However, there’s only so much they can do at home.

“You’re going,” Dean says for the ten millionth time today. “I don’t care if I have to put on a wig and impersonate you--you’re going.” 

Sam pokes at the tuna salad sandwich Dean made him for lunch. “If that’s all you need to do, why don’t you? I’m not going.”

There’s more to recovery than arguing with the patient and insurance. Dean works on moving furniture in the living room to provide an unimpeded path. Why didn’t he ask Kevin or Walter to help him with this crap? Because he’s been sleeping three or four hours a night, that’s why. 

“No time to buy a decent wig,” Dean grumbles. He resists the urge to move the coffee table without using his hands. No. He can’t. Dean has to set an example. 

None of the half dozen specialists assigned to Sam could definitively prove what caused his stroke. 

But why take chances. Stupid chances. 

“We did physical therapy here when you had knee surgery,” Sam counters, an obnoxious, know-it-all tone to his voice that he somehow expects to help his case. 

God damn coffee table. “Yeah, well, tough shit, Sam. We’re leaving in ten.” 

“Nope.”

“Quit saying that shit.”

“Nope.”

“Real mature, professor.” 

“I’m not a professor. I’m adjunct faculty.”

“Sam.”

“What?”

“You’re working on my last nerve, buddy.”

“Am I?” 

“...I’m ignoring that.”

“Am I giving you a hard time, Dean?”

“Y’know, I can’t even crack a joke about that. If you don’t eat that sandwich now, it’s gonna be in the fridge for you when we come back.”

“I hate tuna.”

“Remember all those lectures you gave me about omega-3’s? I’m too tired to repeat them back to you. Just eat the god damn sandwich.”

“I’m not hungry.”

“And I’m not making airplane noises to get a grown man to eat. Eat it.”

The angrier Sam gets, the more his words slur together. “You eat it,” Sam shouts and throws the sandwich down to the ground with his left hand. “Or not! Look, now no one can eat it!” 

Numbers two, three, five, nine, ten, and fifteen come to mind.

  1. Reduce risks or a stroke may strike again: eat a healthy diet, exercise, take medications as prescribed, reduce stress and monitor blood pressure. Sam doesn’t do any of these without a fight.
  2. Many factors influence recovery: where in the brain the stroke occured, how much of the brain was affected, the patient’s motivation, caregiver support, and the quality of rehab. There may have been smaller strokes leading up to the big one. 
  3. Some signs point to physical therapy: caregivers should consider seeking assistance from a physical therapist if their loved one has any of these complaints--dizziness, imbalance that results in falls, difficulty walking or moving around, inability to walk six minutes without stopping to rest, and an increased need for help to engage in daily activities. Sam has all of that. He fell last week with Walter and yesterday with Dean. 
  4. Monitor changes in attitude or behavior: evaluate whether your loved one is showing signs of difficulty controlling their emotions. Two days ago, Sam cried for half an hour straight after a shower, then yelled at Dean for not giving him enough space, and shortly after, Sam’s mug of tea shattered as it sat on the coffee table. 
  5. Stop depression before it hinders recovery: post-stroke depression is common, with as many as 30-50 percent of stroke survivors developing depression in the early or later phases of recovery. It can significantly affect your loved one’s recovery and rehabilitation. Sam refused to talk to the social worker that visited two weeks ago.
  6. Take care of you.



Dean stares at Sam.

Last night, Dean woke up choking on acid from a wicked episode of heartburn. Fuck episodes--at this point it’s season thirteen with no end in sight. He spit out acid, which he had to clean up later, and dragged his body to the bathroom so he could chug some cold water and take a Zantac. For half an hour, he sat in the living room and chewed watermelon gum. 

It sucked.

“I’m going to therapy,” Dean quietly announces. He uses his cane to bend down and pick up the sandwich. “My first session is tomorrow morning. I asked Walter to work two extra hours for it.” Who the fuck made the living room floor so far away? “I think… it’s probably good for at least one of us to talk to a shrink for now. I might as well start.”

Tears build in Sam’s eyes. “So I drove you to therapy.”

“No.” Dean shakes his head. He places the sandwich back on its plate and sets it on the coffee table to toss later. “No you did not. I’ve been reading pamphlets.” He produces his wrinkled, dog-eared Fifteen Things list. “And it… uh, it makes sense. I can’t.” Deep breath. “I’m no good to anyone if I run on empty. It says here, ‘Make time in your life by getting adequate rest and talking to a mental health professional for added support.’ So that’s what I’m gonna do.”

Holy fuck, it feels good to say that.

Now that he can breathe a sliver easier, he sits down on the couch, next to Sam.

“You need to go to PT today. Please.”

Ten minutes later, Sam lets Dean help him into the Impala.

“Could I get a copy of your list?”

“The Fifteen Things?” 

“Yes.”

“Yeah.” 

“...I’m sorry about earlier.”

“I appreciate that.”

“Dean.”

“Hmm.”

“You’re gonna stay, right?”

“You mean for PT or in general?”

“Both.”

“I signed up for both, I’m sticking to both.”

Sam rests his head on Dean’s shoulder. 

  1. Measuring progress matters. 



  
  


**Author's Note:**

> Credit to the actual list, which can be found here: strokeassociation.org.
> 
> Happy Birthday to my precious son, Sam Winchester. <3
> 
> Of course, I wrote angst, but uh... it has a happy(ish) ending??? 
> 
> I've been working on my big bang, but it was soooo nice to swing back here to these two knuckleheads. Comments are love. Thank you for being here. :)


End file.
